How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $7,079Professionalmedian $6,457 · 10th to 90th $4,074 to $11,220
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $7,943.28 | Facility | None | $1,288.25 | $4,168.69 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,168.69 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4,073.80 Median $7,079.46 Typical High $11,748.98 | Professional | None | $4,073.80 | $7,079.46 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $4,168.69 Typical High $8,317.64 | Professional | None | $3,981.07 | $4,168.69 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $9,772.37 | Professional | None | $5,888.44 | $5,888.44 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $6,456.54 | Facility | None | $724.44 | $724.44 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $5,011.87 | Professional | None | $3,890.45 | $4,365.16 | $5,011.87 |
Oscar Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Professional | None | $2,884.03 | $2,884.03 | $3,019.95 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $4,168.69 Typical High $7,943.28 | Professional | None | $3,467.37 | $4,168.69 | $7,943.28 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2,089.30 Median $2,089.30 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | 53 · Discontinued | $831.76 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,090.30 Typical High $3,548.13 | Professional | 54 · Surgery only | $3,090.30 | $3,090.30 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | 56 · Pre-op care only | $416.87 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $2,884.03 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,884.03 | $2,884.03 | $3,311.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,949.84 Median $2,187.76 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,949.84 | $2,187.76 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $794.33 Median $870.96 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $794.33 | $870.96 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $549.54 | $616.60 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $549.54 | $616.60 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | AS · PA/NP assist | $549.54 | $616.60 | $691.83 |
Where North Carolina sits
The same service costs 21.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 15th of 51
$6,457
AK $14,125TX $646
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.